Somatoform Disorder

Abstract

Abstract Introduction Somatoform disorders in primary care are common, ranging from 0.8% to 14.0% of all visits. These disorders are best thought of as unexplained symptoms, a class of illnesses that have changed in their presumed etiology over time, but due to their continuous prevalence, primary care physicians need to learn about the epidemiology, phenomenology, and treatment of somatoform disorders. To increase understanding among trainees, we created this standardized patient (SP) case. Methods The SP presents with multiple complaints, minimal physical findings, and a history consistent with the patient believing the complaints are real. All previous health care providers have been unsuccessful in making a diagnosis. The learner has 20 minutes to complete a focused examination to determine the best course of action, including follow-up points. All materials for SP training and both summative and formative learner evaluation are included. Results This SP case has been implemented successfully with family practice residents. Their informal evaluations were positive and they requested further information. Discussion We used this case primarily with a faculty member interacting with the SP to demonstrate the interview and exam process, but the case is easily adapted for the advanced medical student or resident to perform the history and examination, and create a management and treatment plan. Summative and formative evaluations are possible, using points from checklists that may be utilized for learner assessment.

Keywords

• Somatoform Disorders
• Factitious Disorder
• Malingering